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Emergency Significant Incident Report (Form A-9B)
Administration and Oversight of the Unaccompanied Children Program
OMB: 0970-0547
IC ID: 241074
OMB.report
HHS/ACF
OMB 0970-0547
ICR 202409-0970-009
IC 241074
( )
Documents and Forms
Document Name
Document Type
Form A-9B
Emergency Significant Incident Report (Form A-9B)
Form
A-9B Emergency Significant Incident Report - UC Path Version
Emergency SIR and Addendum (Form A-10A) - UC Path.pdf
Form
A-9B Emergency Significant Incident Report - UC Path Version
Emergency SIR and Addendum (Form A-10A) - UC Path.pdf
Form
A-9B Emergency Significant Incident Report
Emergency Significant Incident Report (Form A-9B).pdf
Form
A-9B Emergency Significant Incident Report
Emergency Significant Incident Report (Form A-9B).pdf
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Emergency Significant Incident Report (Form A-9B)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Mandatory
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
A-9B
Emergency Significant Incident Report - UC Path Version
Emergency SIR and Addendum (Form A-10A) - UC Path.pdf
Yes
Yes
Fillable Fileable
Form
A-9B
Emergency Significant Incident Report
Emergency Significant Incident Report (Form A-9B).pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Community and Social Services
Subfunction:
Social Services
Privacy Act System of Records
Title:
ORR Division of Children's Services Records
FR Citation:
81 FR 46682
Number of Respondents:
216
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
5,616
0
0
0
0
5,616
Annual IC Time Burden (Hours)
8,424
0
0
0
0
8,424
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.